Category: lifestyle

Should I be content with my current salary?

It is common knowledge to seek out what typical starting salaries in your field are when you are looking for employment. Knowing what median salary for those 5+ years in you field is also helpful especially if you are seeking out long term employment.

In my experience, open discussion about income (no matter if you’re a doctor, lawyer, or IT guy) also seems to be taboo as well. I suppose that not having open listings of salaries reduces price fixing, but it also prevents adequate knowledge of how much a specialty is “worth”. In order to know what is fair, you have to know how much you’re worth in order to negotiate. Thus it helps to understand how you bring in revenue for your employer. For a physician, that means understanding how you are paid (prior post) and RVUs (post).

A good starting reference for physicians also includes MGMA and AMGA, which release median data on your expected salaries given a certain amount of production. There is a hefty cost to these publications, although you could potential pitch in with several of your colleagues to pick up a copy, or check with a local academic institution that might have a copy in its libraries.

In most places of the country, physicians can still earn more for working harder (fee-for-service), but be aware if your market includes capitated contracts.  That will limit the potential revenue you can bring into a practice.

Questions? Comments? See below!

[showads ad=responsive]

Do you want to get the latest Smart Money MD posts in you inbox?
Get the FREE Smart Money MD Financial Cheatsheet for signing up!

How much house can I buy on my salary?

As a high-income earning physician, you deserve a McMansion, right? How much house can you buy on your income?

Suppose that you are the average physician that we discussed in an earlier post. You are making $200,000 annually. According to this example, you have approximately $131,000 for living expenses and miscellaneous expenses.

Unless you will be paying for a house entirely with cash, you will likely take out a mortgage. In standard home loan mortgages, a down payment of 20% will usually afford you the lowest interest rate. For a $200,000 home, you will need to scrounge up $40,000 for a down payment, plus a few extra thousand dollars for miscellaneous home expenses such as moving expenses, furniture, and additional taxes.

In our example, if our new physician rents an apartment for the first year and lives a moderately lavish lifestyle, she will have $51,000 left for savings. That leaves plenty to put towards the down payment for If that entire amount is directed towards the down payment on a home, you can purchase a $255,000 home. If our doctor wishes to have a larger home (loan of greater than $417,000), she could take out a jumbo loan.

Now, I know plenty of doctors who live in homes <$250,000, but I would venture a guess that the majority of doctors buy much larger and more expensive homes. How can this be manageable? The truth is that everyone is in a different scenario. Perhaps those with the larger home have a higher income. Perhaps they already have savings from prior jobs, the spouse, family…etc. Perhaps they’ve overextended their income. After all, a large percentage of physicians do not have much savings!

Questions or comments? Sound out below!

[showads ad=responsive]

Top 8 ways I increased my net worth during residency

Previously we discussed tips to supercharge your net worth during residency. The main aspect of your finances that you can truly control are your expenses. The following are some of the methods that helped me increase my net worth during rough times:

  1. I did not own a car. Fortunately I lived in a city where mass transit was somewhat reliable and I also lived close to my workplace. So I saved on car insurance, maintenance, and gas. In contrast, I did live in a high cost of living city, so rent was much more expensive than the average U.S. city. In retrospect, the higher cost of living area far exceeded what I saved by not owning a car. That being said, if I truly needed a car during residency, I would have sought out a 5+ year old used car on Craigslist, preferably from a grad student about to move out of the country and needing to sell immediately. High fuel efficiency would be emphasized, although one key component to saving is to minimize unnecessary driving trips.
  2. I maxed out my on-call allowances monthly. Our residency gave us approximately $10 for meals while on call. This was actually regulated through a meal card that contained roughly $100 a month. Maybe they assumed q3 call on a 30-day month. On days that I needed a meal, I would save on meal costs. Whatever was left over was used to purchase ancillary unhealthy snacks that I might have otherwise bought anyway. YMMV depending on how regulated your program is.
  3. I did not own any new furniture. My bed was given to me by a graduating medical student who bought it new but used it for less than one year (not sure why). My couch, desk, dining table, dresser, and corner table all came used via Craigslist. When I moved, I sold everything at a profit and more than doubled my initial investment after years of using the furniture (while maintaining it in good condition). I was quite fortunate in this regard—I doubt that I’d ever be able to replicate such bartering skills in the future.
  4. I found a Hispanic grocery store that sold dirt-cheap basic foods. Although I’m not sure how much pesticide I actually consumed from buying discount fruits and vegetables, it saved me a lot of money. Cuts of meats were also significantly cheaper than the average grocery store.
  5. I bought discounted food at Whole Paycheck. I discovered that said grocery store sold their blemished fruits at a deep discount and raided their selection every week. A bag of 6 fancy mangoes for $1.50! Or a 5lb bag of limes for $1.50! I once chatted with the fishmonger at the store and discovered that they discarded the fish heads and spines. I once bought 3 keta salmon heads/spines for $1. This is the same fish whose fillets sold for an obscene $28.99/lb. The fishmonger also did not fillet cleanly so the portions I purchased had significant amounts of meat. I used the bones to stew broth for ramen.
  6. I kept limited wardrobe. I don’t believe that I actually purchased any new clothing during residency, especially since I took care of my work clothes. This meant air drying dress shirts and ironing them myself.
  7. I cleaned my own apartment. That meant no housekeeper. Initially I thought that not having maid service as a resident was a no brainer, but it’s amazing how many of my colleagues were paying for a cleaner. It also helped that I did not have much furniture to begin with.
  8. I kept my restaurant tabs in check. I didn’t live in solitude but also kept a close eye on excess spending at fancy restaurants. Stressful jobs often lend themselves to retail therapy.

[showads ad=responsive]

Any other suggestions? Sound out below!

Hidden benefits of washing your own car

wash your own carDIY tasks can save you a good deal of money, especially for many trade tasks like plumbing, carpentry, or basic handiwork. Previously we’ve discussed several DIY tasks for your car:

Some of you doctors out there will argue that you have better use of your time than to repair your car, or that “it’s too risky for my career to be fixing a car”. Yes, the previous articles discuss low-risk tasks that are high-yield. How about something even easier, like washing your own car?

Better yet, what do you think of washing AND waxing your car?

The technical and hardware requirement to wash a car is incredibly low. You’d need an outdoor faucet, which I’d imagine more homeowners or even renters probably have access to. A water hose would cost maybe $15 new (or less used), a $1 water bucket, a fancy $3 spray handle, a $1 sponge, a $5 bottle of super fancy car wash solution (should last 100 washes), and maybe a microfiber towel ($5) for drying the car. If you want to wax your car (you should), spend an extra $10 for nice TurtleWax. That adds up to less than $40 for all the equipment you’d need to wash and wax your car.

[showads ad=responsive]

If you take your car to the carwash, you will spend at least $5 for each wash (maybe closer to $8+ for nicer washes). The last time I checked out the cost of hand waxing a car was $50!

This means that after ONE car wash/wax job, you’d recoup the cost of your supplies!

Wait a second, buddy! As a general surgeon, I’m making $150 an hour! Washing and waxing my car would take an hour of my time! I’m actually losing money by washing my own car.

That’s absolutely true if you’d rather be doing an emergency appendectomy on a weekend rather than washing your car. It’s also true if there is an emergency for you to perform. This doesn’t even take into account the stress and liability that you incur in your profession.

Aside from the financial benefits of washing your car, there are health benefits. Hand waxing a car is not easy. Forearm muscles are used, and I burned at least 200 calories for an hour of work (use your favorite calorie tracking device to confirm). This free exercise that not only saves you money but also makes you healthier!

Questions? Sound out below!

Your car determines your savings level

You think that as a high income earner, you have the luxury of splurge purchases. You do, but these expenses do cut into your savings rate, much more than you’d think.

Suppose you decide to buy a luxury weekend car that is fitting for a hotshot doctor: The Mercedes E63 AMG. 550 horsepower in a V8 engine. You can probably get a little over 20mpg on the highway. If you buy it from the dealer and get a deal, you might be able to get for around $100,000 out the door. If you are a deal finder and troll eBay for a used model, you might be able to get a 3 year old model for around $60,000. A deal, right?

With an excellent credit score, you could even score a great interest rate. A $60,000 vehicle could be financed for 5 years at around $1,000 a month.

Maybe add in a few thousand dollars a year for insurance and maintenance costs, the fancy weekend car is still worth it!  Premium gas at $3.60/gal and a lousy fuel economy will also add few thousand dollars a year to the upkeep.

As a doctor with an income of over $10,000 a month, you can surely afford a splurge. Maintaining a luxury car might only cost you $1,500 a month for 5 years, and then drops off precipitously after you pay off the car. That’s an annual cost of only $18,000!

Back to reality though: your $18,000 comes at a cost of post-tax dollars. Remember our previous article, you have to earn quite a bit more than that in order to pay for the car. If equivalent pre-tax dollars are used, you can fund an entire 401k/403b for an entire year.

The decision is yours whether you think that you can afford the luxury. Take a look at AMA’s Physician Survey data, and then you start wondering how high income physicians still have a relatively low net worth.

[showads ad=responsive]

Doctors are not paid enough for their services

There has been a public belief for decades that doctors are among the wealthiest in the country, and that they are overpaid for their services. Those who care to pay attention to the evolution of the health system are also aware that payments for physician services have progressively slashed by insurers.

That being said, the majority of my patients still have a poor understanding about how doctors are paid and the work that goes into being a healthcare provider. I have overheard comments from patients that go along the lines of this:

“These doctors spend less than 10 minutes with me and I get hit with a bill for a few hundred dollars. They have it all good.”

“She always wears such fancy clothes. Docs have so much money.”

“I work just as hard as this doc. Why does she get paid so much more than me?”

While this is just a slice of what I’ve only heard, it is clear that much of this stems of ignorance. I will analyze the topics to clear the air:

1. What you see on your bill is not what your doctor gets to keep. For instance, you may see what your doctor billed your insurance company $300 for your care. In a fee-for-service model, the contracted rate may only be $130. The billing company may then take another 3-5% for its services in helping the doctor collect from the insurance company. If the doctor is unlucky, the insurance company may even deny/reject a claim due to documentation issues and get nothing. After everything is done, the practice collects maybe $125. That amount goes toward paying for the clinic’s utilities, front desk person, technician, computer systems, diagnostic equipment, cleaning services, and all other costs relating to operating the clinic. I’ve seen practices with operational costs in the 90+% range. If your doctor is employed by the practice, another cut may be taken out by the practice owners. Maybe if your doctor is reimbursed more appropriately, then she might actually have more time to spend with you.

2. While it is your doctor’s own business what she wears to work, would you consider your doctor to be less competent if she were disheveled and wore dirty clothes? What if the fancy-appearing clothing were actually purchased third-hand at a thrift shop? I have certainly had patients with life-threatening medical conditions who refused to pay the $20 copay but was willing to own fancy iPhones, Ray-Ban sunglasses, bling, or even get $100 massages. Ultimately it all lies in where your priorities are.

3. There are very few good paying occupations that aren’t challenging in some form (physical or mental). As a plumber I can bill for $100 an hour and even include the time it takes me to find a part that I need in the store (and I can charge you for the part). The 30 seconds of medical decision making that a doctor undergoes took many years (a decade) of sacrifices to learn. Even after making that decision, there are still ramifications that has to be considered. It doesn’t end. Obviously there is a price placed on a doctor’s ability. There’s also a fine line to what a doctor is worth. What should be known is that if that value of a doctor is discounted enough, those who are most competent will quit.

Comments? Questions? Sound out below!

[showads ad=responsive]

41% of all doctors have less than $500,000 in savings

You would think that the majority of doctors are financially well off, but in fact, they are not. According to the AMA 2013 Physician Financial Preparedness Survey, only 41% of all physicians average less than $500,000 in retirement savings. In fact, of the physicians surveyed, the majority (56%) of those under age 40 had an average retirement savings under $100,000! That is disturbing. In comparison, Whitecoatinvestor had a net worth that exceeded $1,000,000 before he reached age 40!

Given that the average doctor should earn more than $100,000 annually, it is natural to assume that she would have more than that amount after a decade of working (assuming starting at age 30). The fact that there still is such a discrepancy become income, net worth, and retirement savings signifies that doctors are not probably not saving enough for retirement. Actually, the top financial concern of all physicians was whether they had enough to retire.

In actuality, financial stability is achievable for all physicians—you don’t even have to spend every waking second of your time managing your finances. BUT, you do have to pay attention to your expenses and allocate your earnings appropriately.

 

[showads ad=responsive]